Botulinum toxin type A in pediatric urological practice: current state of the problem and future perspectives

Botulinum toxin was used in medicine in the middle of the 20th century. Studies in various fields around the world have proven its high safety profile and are successfully used in clinics in different countries. In pediatric urology, botulinum toxin is used for chemodenervation of the bladder detrusor and urethral sphincter. The main contingent for the use of botulinum toxin type A (BTTA) is children with myelodysplasia (that is, with organic lesions of the spinal cord and, as a result, impaired innervation of the pelvic organs), the manifestations of which are urgency urinary incontinence, which represents a significant deterioration in the quality of life and difficulties in socialization and normal life of children. In addition, gallbladder-dependent ureterohydronephrosis is often found in these patients, as a result of hyperactivity and hypertonicity of the detrusor, increased intravesical pressure and the presence of residual urine. In both of the above cases, chemodenervation of the detrusor using botulinum toxin shows excellent results, and therefore this method is gaining popularity all over the world. Nevertheless, in pediatric practice, the indications for the introduction of BTTA are not clearly formulated, and there are currently few studies and, accordingly, the results of its use. The aim of this work is to review the accumulated data on the use of BTTA and their interpretation.